Contracting Provider definition

Contracting Provider means any physician, health care professional, health care facility or Contracting Pharmacy Provider that has contracted with CareFirst BlueChoice, Inc. to render Covered Services to Members. A Preferred Dentist who provides Covered Dental Services or a Contracting Vision Provider who provides Covered Vision Services is not a Contracting Provider for the purposes of this definition. Contracting Vision Provider means any optometrist or ophthalmologist licensed as such by the duly constituted authority in the jurisdiction in which Covered Vision Services are rendered when acting within the scope of such license; and that has contracted with the Vision Care Designee to provide Covered Vision Services.
Contracting Provider means a Provider who has signed a Contract with this Company to provide the services covered by this Benefit Certificate to Covered Persons. The Company will pay the Contracting Provider directly.
Contracting Provider means any physician, health care professional, health care facility, or Contracting Pharmacy Provider that has contracted with CareFirst BlueChoice, Inc. to render Covered Services to Members. A Preferred Dentist who provides Covered Dental Services or a Contracting Vision Provider who provides Covered Vision Services is not a Contracting Provider for the purposes of this definition. Contracting Vision Provider means any optometrist or ophthalmologist licensed as such by the duly constituted authority in the jurisdiction in which Covered Vision Services are rendered when acting within the scope of such license and that has contracted with the Vision Care Designee to provide Covered Vision Services. Convenience Item means personal hygiene and convenience items, including, but not limited to; air conditioners, humidifiers, physical fitness equipment, elevators, xxxxx/stair lifts, ramps, shower/bath benches, and items available without a prescription. Copayment (Copay) means the fixed dollar amount that a Member must pay for certain Covered Services, Covered Dental Services or Covered Vision Services. Cosmetic means a service or supply which is provided with the primary intent of improving appearance, not restoring bodily function or correcting deformity resulting from disease, trauma, or previous therapeutic intervention, as determined by CareFirst BlueChoice.

Examples of Contracting Provider in a sentence

  • It is the Member’s responsibility to apply any CareFirst BlueChoice payments to the claim from the Non- Contracting Provider charge.

  • Contracting Provider services provided to a hospitalized Member, including physician visits, charges for intensive care, or consultative services, only if CareFirst BlueChoice determines that the Contracting Provider rendered services to the Member and that such services were medically required to diagnose or treat the Member’s condition.

  • Contracting Provider means any physician, health care professional, health care facility, or Contracting Pharmacy Provider that has contracted with CareFirst BlueChoice, Inc.

  • A Preferred Dentist who provides Covered Dental Services or a Contracting Vision Provider who provides Covered Vision Services is not a Contracting Provider for the purposes of this definition.

  • The Member and the Contracting Provider may agree to an early discharge.Non-routine care of the newborn, either during or following the mother’s covered hospitalization, requires that the newborn be covered as a Member in the newborn’s own right.


More Definitions of Contracting Provider

Contracting Provider means a physician or other health care
Contracting Provider means any medical group or medical organization, physician (also referred to herein as "Contracting Physician"), hospital (also referred to herein as "Contracting Hospital") and other health care providers, who have entered into a written agreement with Company to provide Covered Services to Members.
Contracting Provider means any licensed physician who has contracted with a particular insurance company and is considered in-network.
Contracting Provider means any Physician or Allied Health Professional who provides medical or health care services by and through the Practice as an independent contractor of VA, and does not include providers who contract with VA to provide Outside Provider Services.
Contracting Provider. MEANS A PHYSICIAN OR OTHER HEALTH CARE PROVIDER WHO ENTERS INTO AN ADMINISTRATIVE SERVICE PROVIDER CONTRACT
Contracting Provider means each licensed health care provider that is employed by or otherwise under contract with Provider to provide Eye Health Care Services to Enrollees hereunder.
Contracting Provider means a person who enters into an administrative service provider contract with an HMO. An external provider is a health care provider, including a physician or hospital, that is not a contracting provider or employee, shareholder, or partner of a contracting provider.